Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2020; 26(21): 2715-2728
Published online Jun 7, 2020. doi: 10.3748/wjg.v26.i21.2715
Alternative uses of lumen apposing metal stents
Prabin Sharma, Thomas R McCarty, Ankit Chhoda, Antonio Costantino, Caroline Loeser, Thiruvengadam Muniraj, Marvin Ryou, Christopher C Thompson
Prabin Sharma, Antonio Costantino, Caroline Loeser, Department of Gastroenterology and Hepatology, Yale-New Haven Health-Bridgeport Hospital, Bridgeport, CT 06610, United States
Thomas R McCarty, Marvin Ryou, Christopher C Thompson, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States
Ankit Chhoda, Department of Internal Medicine, Yale-New Haven Health-Bridgeport Hospital, Bridgeport, CT 06708, United States
Thiruvengadam Muniraj, Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT 06520, United States
Author contributions: Study concept and design: Sharma P and McCarty TR; Paper preparation: Sharma P and McCarty TR; Critical revisions: Sharma P, McCarty TR, Chhoda A, Costantino A, Loeser C, Muniraj T, Ryou M, and Thompson CC.
Conflict-of-interest statement: Sharma P has no conflicts to disclose. McCarty TR has no conflicts to disclose. Chhoda A has no conflicts to disclose. Costantino A has no conflicts to disclose. Loeser C has no conflicts to disclose. Muniraj T has no conflicts to disclose. Ryou M has the following disclosures: Medtronic/Covidien (Consultant), Boston Scientific, Olympus (Consultant), and Pentax (Consultant). Christopher C Thompson has the following disclosures: Apollo Endosurgery–Consultant/Research Support (Consulting fees/Institutional Research Grants), Aspire Bariatrics–Research Support (Institutional Research Grant), BlueFlame Healthcare Venture Fund–General Partner, Boston Scientific–Consultant (Consulting fees), Covidien/Medtronic–Consultant (Consulting Fees), EnVision Endoscopy (Board Member), Fractyl–Consultant/Advisory Board Member (Consulting Fees), GI Dynamics–Consultant (Consulting Fees)/ Research Support (Institutional Research Grant), GI Windows–Ownership interest, Olympus/Spiration–Consultant (Consulting Fees)/Research Support (Equipment Loans), Spatz–Research Support (Institutional Research Grant), USGI Medical–Consultant (Consulting Fees)/Advisory Board Member (Consulting fees)/Research Support (Research Grant).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Prabin Sharma, MBBS, MD, Department of Gastroenterology and Hepatology, Yale New Haven Health- Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, United States.
Received: January 1, 2020
Peer-review started: January 1, 2020
First decision: February 19, 2020
Revised: March 27, 2020
Accepted: May 13, 2020
Article in press: May 13, 2020
Published online: June 7, 2020

The advent of lumen apposing metal stents (LAMS) has revolutionized the management of many complex gastroenterological conditions that previously required surgical or radiological interventions. These procedures have garnered popularity due to their minimally invasive nature, higher technical and clinical success rate and lower rate of adverse events. By virtue of their unique design, LAMS provide more efficient drainage, serve as conduit for endoscopic access, are associated with lower rates of leakage and are easy to be removed. Initially used for drainage of pancreatic fluid collections, the use of LAMS has been extended to gallbladder and biliary drainage, treatment of luminal strictures, creation of gastrointestinal fistulae, pancreaticobiliary drainage, improved access for surgically altered anatomy, and drainage of intra-abdominal and pelvic abscesses as well as post-surgical fluid collections. As new indications of endosonographic techniques and LAMS continue to evolve, this review summarizes the current role of LAMS in the management of these various complex conditions and also highlights clinical pearls to guide successful placement of LAMS.

Keywords: Lumen apposing metal stents, Walled off necrosis, Gallbladder drainage, Biliary drainage, Gastric access temporary for endoscopy, Gastric outlet obstruction, Therapeutic endoscopy

Core tip: Lumen apposing metal stents have become widely adopted as a preferred modality in the treatment of pancreatic walled-off necrosis, with even broader applications for multiple alternative conditions. Current literature suggests that the use of these novel stents may significantly improve treatment response and provide a much needed minimally invasive therapeutic option to patients in need.